Research ArticleMultiple Sclerosis

An RNA Profile Identifies Two Subsets of Multiple Sclerosis Patients Differing in Disease Activity

Science Translational Medicine  26 Sep 2012:
Vol. 4, Issue 153, pp. 153ra131
DOI: 10.1126/scitranslmed.3004186

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Blood Cell RNA: A Crystal Ball for MS?

Multiple sclerosis (MS) is a devastating inflammatory disease that affects primarily the brain and spinal cord; a key challenge in MS remains the clinician’s inability to predict which patient will do well on a given drug. In a new study, Ottoboni et al. took RNA from peripheral blood cells—cells that play a key role in MS attacks and are the target of current therapies—and developed a profile that identified two subsets of patients. These two subsets were seen in untreated patients as well as in patients treated with one of the two first-line MS therapies: glatiramer acetate (GA) and interferon-β (IFN-β). The RNA signature pointed to molecular pathways involved in immune cell activation as being key in differentiating these two subsets of patients. Patients in one of the two subsets, which was called MSA, were more likely to have MS attacks when treated with either GA or IFN-β. This RNA signature from the peripheral blood of MS patients may be able to help identify individuals who are more likely to relapse when treated with first-line MS drugs. If validated in future studies, this signature could become part of a tool to help neurologists identify those MS patients at higher risk of attacks, who would benefit from more aggressive treatment up front.